Efficacy of platelet-rich plasma as an adjuvant to surgical carpal ligament release: a prospective, randomized controlled clinical trial.

The purpose of this study is to evaluate the efficiency of local platelet-rich plasma (PRP) injection as an adjuvant treatment after carpal ligament release. We conducted a prospective randomized, triple-blinded, controlled trial. Fifty participants with mild to extreme carpal tunnel syndrome (CTS) were randomly assigned either to the PRP (n = 25) or the platelet-poor plasma (PPP, n = 25) group. After performing open surgical release of the carpal ligament, the inside of the carpal tunnel was irrigated with 3 mL of PRP or PPP according to each participant's group allocation. The primary outcome was hand grip strength (HGS). Secondary outcomes were the time taken off work after surgery (in days) and scores on the Wong-Baker Faces Scale, Boston Carpal Tunnel Questionnaire, and Southampton Wound Assessment Scale. We evaluated patients before treatment and at 6-weeks. As expected, the pain levels, symptom severity, and functional status improved in all the patients after surgery. However, intragroup analysis revealed that only the participants in the PRP group had regained their pre-operative HGS levels at 6-weeks follow-up. These findings indicate that PRP is an effective adjuvant treatment in patients with mild to severe CTS who require surgery.

Reconstruction of the medial patellofemoral ligament for patellar instability using a semitendinosus autograft.

Between 1999 and 2001 thirty knees underwent a semitendinosus tendon plasty to recreate the medial patellofemoral ligament for recurrent patellar dislocation. The mean follow-up was 38 months. The mean improvement of the patellofemoral congruence angle after surgery was 14 +/- 7 degrees. All patients ended up with a full range of motion, except one patient, whose flexion was limited to 120 degrees due to superficial wound infections. Dislocation did not recur. According to the Larsen and Lauridsen outcome score the clinical results were excellent in 27 patients, good in 2 and fair in one. In conclusion this procedure is indicated for the chronic dislocation and cases of severe femoral dysplasia with marked laxity. The procedure assures the stabilisation of the patella, although it doesn't restore the patellofemoral congruence angle to normal values.